淋巴增强因子1在中危急性髓系白血病患者中的表达及其临床意义

Expression of lymphoid enhance factor 1 in acute myelogenous leukemia patients with intermediate-risk and its clinical significance

目的 定量分析中危急性髓系白血病（AML）患者初诊及化疗后骨髓单个核细胞中淋巴增强因子1（LEF-1）mRNA表达水平,并分析其临床意义.方法 应用实时荧光定量聚合酶链反应测定LEF-1基因在中危AML患者初诊及化疗后的表达水平,分析其与治疗反应及生存等的关系.结果 中危AML患者初诊时LEF-1 mRNA相对表达水平高于正常对照[0.00519（0.00015～0.09207）比0.00101（0.00009～0.00233）],差异有统计学意义（u=134.50,P〈0.01）,化疗后LEF-1 mRNA相对表达水平较化疗前下降[0.00107（0.00008～0.00744）比0.00519（0.00015～0.09207）],差异有统计学意义（u=317.00,P〈0.01）;完全缓解（CR）患者化疗前LEF-1 mRNA相对表达水平高于非CR患者化疗前[0.01108（0.00164～0.09207）比0.00110（0.00015～0.00916）],差异有统计学意义（u=19.00,P〈0.01）.LEF-1 mRNA表达水平较高的AML患者总生存期更长（χ2=4.549,P=0.033）.结论 LEF-1可能与中危AML的发生、发展有关,且与其肿瘤负荷量及疗效密切相关.LEF-1表达水平可能成为评估中危AML患者预后的指标,且可能成为有效治疗AML的新靶点.

Objective To quantitatively analyze the mRNA expression level of lymphoid enhance factor 1 （LEF-1） in bone marrow mononuclear cells of patients with acute myeloid leukemia （AML） at intermediate-risk after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction （RT-PCR） was used to measure the expression level of LEF-1 gene in AML patients at intermediate-risk after initial diagnosis and chemotherapy, and its relationship with effectiveness and survival were analyzed. Results The LEF-1 mRNA level in preliminarily diagnosed patients with AML was significantly higher than that in control arm [0.00519 （0.00015-0.09207） vs. 0.00101 （0.00009-0.00233）], and the difference was statistically significant （u=134.50, P〈0.01）. The LEF-1 mRNA level in patients after chemotherapy was significantly declines as compared to that in patients before chemotherapy [0.00107 （0.00008 - 0.00744） vs. 0.00519 （0.00015 - 0.09207）], and the difference was statistically significant （u= 317.00, P〈 0.01） and LEF-1 mRNA expression level before chemotherapy in complete remission （CR） patients was significantly higher than that in non-CR patients [（0.01108 （0.00164 - 0.09207） vs. 0.00110 （0.00015 - 0.00916）], and the difference was statistically significant （u=19.00, P〈0.01）. High LEF-1 expression predicted a significantly better overall survival in AML patients with intermediate-risk cytogenetics （χ2= 4.549, P= 0.033）. Conclusions LEF-1 may be involved in the development and progression of AML at intermediate-risk patients and is closely related to tumor burden and treatment efficacy. LEF-1 may be a good predictor of better prognosis and a novel target for therapeutic effect.